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Jumat, 01 April 2011

Eye Health and the Role of Nutrition

Medical research is now finding that nutrition plays the most important role in eye health and in the prevention of major age-related eye diseases such as Age-Related Macular Degeneration (ARMD), Cataracts, Glaucoma and Diabetic Retinopathy.
The study, ‘Age-Related Eye Disease Study (AREDS), by National Eye Institute (NEI) showed that some nutrients and vitamins can prevent major age-related eye diseases by up to 39%.
Carrots contain beta-carotenes, and beta carotenes are converted by the body to create Vitamin A - which plays a key role in the bio-electrical processes in the eye - and also help the body to rid itself of free radicals.

Other foods that contain Vitamin A and beta carotene are:
• Beef Liver
• Chicken Liver
• Sweet Potato
• Kale
• Butternut Squash
• Red Pepper
• Mango
• Cantaloupe

Vitamin C and bioflavonoid can not only reduce the risk of cataracts, but also contain antioxidants that help rid the body of free radicals. Studies have also linked Vitamin C to the prevention of Glaucoma by regulating intraocular pressure.

Some foods that contain Vitamin C are:
• Red Pepper
• Kale
• Broccoli
• Green Pepper
• Strawberries
• Cantaloupe
• Grapefruit

Lutein and its advantages to eye health have recently undergone comprehensive study (such as with the AREDS study mentioned above). Medical research has found that lutein may have even higher health benefits to your eyes than Vitamin A.
Some foods that contain Lutein are:
• Spinach
• Kale
• Collard Greens

Vitamin E is another essential vitamin to complete eye health. Some studies have shown that Vitamin E can reduce the risk of developing advanced Age-Related Macular Degeneration by up to 25%.
Some foods that contain Vitamin E are:
• Almonds
• Hazelnuts
• Sunflower seeds
• Flax seed oils can promote excellent eye health. They are rich in essential fatty acids, particularly Omega-3 fatty acids, which work throughout the body to protect cell membranes. Selenium (found in yeast, seafoods and Brazil nuts) and zinc (found in oysters, wheat, nuts and hamburgers) help your body to absorb and convert many of the vitamins listed above. In addition, zinc plays a major role in the enzymes responsible for ridding your body of antioxidants.
• Bilberries contain natural antioxidants which strengthen blood vessels (including those in and around the eye). Bilberry also contains both Vitamin A and Vitamin C. Chromium can also be found in bilberries, and is responsible for regulating blood sugar levels (protecting small blood vessels and overall health). Lastly, bilberries have been shown to regulate intraocular pressure, thereby lessening the risk of developing Glaucoma.


How Nutrients Work for Eyes

Beta Carotene is converted into a form of vitamin A called retinols.
Retinols have numerous functions in the body, including assisting the bio-electrical process of vision (preventing loss of night vision) and eliminating damaged cells from the body (thus helping to prevent dry macular degeneration for example).
Lutein and beta-carotene are also antioxidants consisting of free radicals that help the eye in numerous ways, most importantly regulating cell health and ridding the body of extra-cellular growths, a key trigger of age related macular degeneration (ARMD). Antioxidants have also been shown to reduce the risk of cataracts.
Bilberries play a significant role in both eye health and in preventing age-related eye disease. Among its eye health benefits are anthocyanoside, antioxidants that strengthen blood vessels (reducing the chances of blood vessel hemorrhaging in macular degeneration and diabetic retinopathy).
Zinc and selenium have positive effects on the eyes and also help your body to absorb both Vitamin A and Vitamin E, key vitamins in eye health.


Age-Related Eye Diseases (AREDs)

Your eyes are one of the most important organs in your body, and perform what many believe to be the most important of the 5 senses. As people get older, their bodies become more susceptible to diseases and ailments, and their eyes are no exception. The National Eye Institute (NEI), as part of the National Institute of Health, has performed extensive studies on age-related eye diseases, now coined AREDs.
Age-related eye diseases, in many cases, are not sudden, but tend to develop slowly as a person ages.
There are four major ones that are recognized by the NEI. These four age-related eye diseases are Macular Degeneration, Cataracts, Glaucoma and Diabetic Retinopathy.




Macular Degeneration





Macular Degeneration can be particularly difficult to live with because it affects the central vision. This means that the loss of vision takes places at the spot where your eyes are trying to focus, and not necessarily the peripheral vision.
People who suffer from Macular Degeneration have difficulties recognizing faces, driving, reading and taking part in any daily activities that require direct sight. Macular Degeneration is the leading cause of non preventative blindness in the United States, and affects over 2 million people over the age of 65.
Macular Degeneration:
• caused by deposits in the eye or abnormal blood vessel growth in the eye
• affects central vision
• can go unnoticed while it develops; can develop rapidly resulting in legal blindness
• no known cure

The macula is small oval layer of ganglion cells at the center of the retina (the retina is located at the back of the eye where come cells absorb light and enable you to see).
The macula is usually about 5mm in diameter, and is yellowish in color (it is sometimes called the macula lutea, or "yellow spot"). Its position in the center of the retina is conducive to its job of providing central vision.

The macula or macula lutea (from Latin macula, "spot" + lutea, "yellow") is an oval-shaped highly pigmented yellow spot near the center of the retina of the human eye. It has a diameter of around 5 mm and is often histologically defined as having two or more layers of ganglion cells. Near its center is the fovea, a small pit that contains the largest concentration of cone cells in the eye and is responsible for central vision, and also contains the parafovea and perifovea.
Because the macula is yellow in color it absorbs excess light that enters the eye and acts as natural sunglasses.
It is specialized for high acuity vision. Within the macula are the fovea and foveola which contain a high density of cones (photoreceptors with high acuity).

Macular Degeneration is grouped into two types: dry and wet. 'Dry' Macular Degeneration affects about 90% of people with this age-related eye disease, and ‘wet’ Macular Degeneration affects about 10%.

Dry Macular Degeneration (Nonexudative Macular Degeneration):

Dry Macular Degeneration refers to a condition where the cells below the retina, on the retinal pigment epithelium, start to break down due to a build-up of drusen.
Drusen is a common extra-cellular deposit in the eye that tends to become more frequent with age. When this deposit starts to interfere with the retinal pigment epithelium, rod and cone cells in the area start to degenerate or atrophy.
Because rod and cone cells literally absorb and decipher light, thereby enabling us to see, the atrophy of rod and cone cells impairs our vision. Because of the area of atrophy (the macula, or the center of the retina), the result is central vision loss.
About 90% of all people who suffer from Macular Degeneration are diagnosed with the dry or nonexudative type. Dry Macular Degeneration seems to have less of an effect on vision than does Wet Macular Degeneration because the atrophy of rod and cone cells tends to be much slower.

Wet Macular Degeneration (Exudative or Neovascular):

Wet Macular Degeneration is similar to Dry Macular Degeneration in the sense the macular degenerates, resulting in the loss of central vision.
In this degeneration type, abnormal blood vessel growth is triggered in the choriocapillaries (the choroids is also located behind the retina), resulting in the leakage of blood and protein.
The resulting fluid leakage and overgrowth of blood vessels can quickly damage the macula and its rod and cone cells, resulting in severe loss of central vision.
The major symptomatic difference is that Wet Macular Degeneration progresses quickly and can cause legal blindness in a relatively short time. Although Wet Macular Degeneration only affects about 10% of people suffering from Macular Degeneration, the quickness of degeneration and the massive amount of vision loss can be devastating.
About 10% of people between the ages of 66 and 74 are detected to have Macular Degeneration. These statistics can increase fourfold if someone else in your family has suffered from Macular Degeneration.
Although the disease is not curable, research studies by the National Eye Institute have found that certain vitamins and minerals can significantly reduce the risk of Macular Degeneration.
Some of these include Beta-Carotene, Vitamin C, Vitamin E, zinc, bilberries, lutein and certain fish oils, vitamins and nutrients your body needs but are sometimes either neglected or not absorbed properly in elderly peoples.

Glaucoma
Glaucoma is the second leading cause of blindness worldwide, affecting one person in every 200.
The disease (or group of diseases) usually goes undetected until it is fairly advanced. Because of this ‘creeping’ affect, it has often been called the "thief of the night" or "sneak thief of sight" - indeed, its progression can be so slow that people with glaucoma don’t even realize that their vision has deteriorated by up to 50%.
Glaucoma:
• caused by increased intraocular pressure (IOP)
• starts by affecting peripheral vision
• usually goes unnoticed until relatively advanced
• no known cure

Glaucoma is the result of high intraocular pressure, resulting in optic nerve damage and damage to retinal ganglion cells.
The eye itself is constantly being irrigated by a flow of clear liquid that both replenishes the cells of the eye, but also maintains a certain pressure on the eye, called intraocular pressure. This pressure varies from person to person; an intraocular pressure that causes optic nerve damage in one person may be a perfectly healthy intraocular pressure for another.
Glaucoma causes permanent damage to the optic nerve, which results in the gradual loss of the visual field. So, unlike Macular Degeneration, the peripheral vision is affected first, slowly 'tunneling' off to the central vision.
The fact that Glaucoma affects the peripheral vision explains why so many people do not even know they have Glaucoma until it has advanced significantly.
There is no cure for Glaucoma. Some surgeries can be performed for some types of Glaucoma, but their results are temporary.
Prescription drugs are available to control intraocular pressure (IOP); some examples are Physostigmine, Litanoprost, Bimatoprost, Epinephrine and Dorzolamide.
With the resurgence of natural healing and remedies, recent studies have shown that many natural compounds and ingredients can not only help reduce IOP, but can actually nourish the optic nerve and help regulate eye irrigation.
Some of these natural compounds include fish oil, bilberries, Vitamin A, C and E, Beta-carotene, Selenium and many more.

Cataracts
Cataracts are a clouding of the lens within the eye, which causes lack of vision and can lead to blindness. The clouding affects the crystalline lens of the eye, and is particularly common in aged people (called senile cataracts) and is considered an age-related eye disease.


Bilateral cataracts in an infant due to
Congenital rubella syndrome

If untreated, cataracts can cause a person to lose perception of certain colors (usually blue) and can lead to vision loss.

Cataracts:
• Various causes including genetics, diabetes, radiation exposure, trauma and denaturation of lens protein
• Affects central vision
• Can cause blindness if left untreated
• Can be cured with surgery and prevented with certain vitamins



Normal vision .Vision with cataract

Cataracts affect over 18 million people worldwide, and are the leading cause of blindness in some underdeveloped countries.
Predominant in elderly people, cataracts affect over 40% of people between 52 and 64 and more than 60% of people over the age 65. Some statistics show a 90% prevalence of cataracts in the elderly over the age of 90.
Cataracts are caused, as mentioned, by the denaturation of proteins in the crystalline lens of the eye. The crystalline lens is located behind the cornea (the bulge on the outer front of the eye) and the aqueous humor (the liquid pocket behind the cornea).
The lens is made of various elements including water and proteins which are important for the lens’ structure and flexibility, and are arranged in such a way to focus light onto the retina at the back of the eye.
Certain triggers can cause the proteins to ‘cloud’ causing loss of visions and the onset of a cataract. A good analogy of this is the proteins in the ‘white’ of an egg. Initially clear, if you add heat to the egg white, it will start to cloud until, with enough heat, it becomes completely white (opaque).
Denaturation of the proteins in the crystalline lens works the exact same way. The triggers, however, are numerous and not completely understood by medical research.
Heat and thermal trauma to the eye can cause a cataract in exactly the same way an egg white turns white. Other factors, particularly radiation, can cause the proteins to cloud over. Other causes have been related to allergies, ultraviolet light (or severe sun exposure), corticosteroid use and vitamin deficiencies.
Cataracts can appear and never get worse (stationary cataracts) or can progressively get worse even if the assumed cause has been isolated and eliminated (progressive cataracts).
Unlike many age-related eye diseases, cataracts can be treated and cured through surgery. In many cases, the lens of the eye is actually replaced by a plastic lens which is impervious to protein denaturation. When surgery is performed, lenses are created that will also cure certain sight issues, particularly short sightedness, which can be a symptom of cataracts.
Like many eye diseases, research has shown that proper nutrition and the intake of daily recommended vitamins such as Vitamin A, C and E may help to prevent cataracts. Studies are now being done on the efficacy of these antioxidants. It should be noted that the use of ultraviolet protecting sunglasses can help reduce the chance of getting a cataract, or slow the progression of a cataract.

What are the symptoms of a cataract?
The most common symptoms of a cataract are:
• Cloudy or blurry vision.
• Colors seem faded.
• Glare. Headlights, lamps, or sunlight may appear too bright. A halo may appear around lights.
• Poor night vision.
• Double vision or multiple images in one eye. (This symptom may clear as the cataract gets larger.)
• Frequent prescription changes in your eyeglasses or contact lenses.
• These symptoms also can be a sign of other eye problems. If you have any of these symptoms, check with your eye care professional.

Diabetic Retinopathy
Retinopathy generally means damage to the retina.
Diabetic retinopathy is damage to the retina caused by the effects of diabetes mellitus. Diabetic Retinopathy affects almost 80% of people who have had diabetes for more than 10 years. Although diabetic retinopathy may not always cause blindness, the symptoms of the eye disease can come and go very quickly, often overnight.
Diabetic Retinopathy affects people with both Type I and Type II diabetes.

Retinopathy:
• blood vessels in the eye weakening and/or hemorrhaging due to diabetes mellitus
• can affect central or peripheral vision or both
• can cause blindness if left untreated
• can be treated with surgery or certain steroids

When a person has diabetes, their blood vessels (particularly the smaller vessels like those in the eye) can become weakened and prone to hemorrhaging due to over-accumulation of blood sugar (glucose/fructose).
When the blood vessels at the back of the eye are weakened, they cannot provide proper nutrients to the retina. At this stage, called nonproliferative diabetic retinopathy (NPDR), the person may experience a blurring of the vision but in many cases will not notice any change in their vision.
Once the blood vessels are weakened enough, they start to hemorrhage. The resulting fluids can then obstruct the macula, causing a condition called macular edema (swelling of the macula) and cause blurring vision.
Proliferative Diabetic Retinopathy (PDR) occurs when NPDR advances to the point where lack of oxygen to the retina (caused by weakened or hemorrhaging blood vessels) stimulates the growth of new blood vessels directly on the retina.
The new blood vessels will cause blurred vision. If the blood vessels then start to bleed (as is common), the resulting fluid can block the retina (causing spotted vision or complete loss of sight), and can actually damage the retina or cause it to detach.
PDR can be treated in a variety of ways, but it cannot be cure and must be frequently monitored to make sure the retina is not being damaged. Some surgeries, such as laser surgery, can be used to eliminate new blood vessels growing on the retina.
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HERBAL MEDICINE

What is herbal medicine?
Herbal medicine -- also called botanical medicine or phytomedicine -- refers to using a plant's seeds, berries, roots, leaves, bark, or flowers for medicinal purposes. Herbalism has a long tradition of use outside of conventional medicine. It is becoming more mainstream as improvements in analysis and quality control along with advances in clinical research show the value of herbal medicine in the treating and preventing disease.
What is the history of herbal medicine?
Plants had been used for medicinal purposes long before recorded history. Ancient Chinese and Egyptian papyrus writings describe medicinal uses for plants. Indigenous cultures (such as African and Native American) used herbs in their healing rituals, while others developed traditional medical systems (such as Ayurveda and Traditional Chinese Medicine) in which herbal therapies were used. Researchers found that people in different parts of the world tended to use the same or similar plants for the same purposes.
In the early 19th century, when chemical analysis first became available, scientists began to extract and modify the active ingredients from plants. Later, chemists began making their own version of plant compounds, and over time, the use of herbal medicines declined in favor of drugs.
Recently, the World Health Organization estimated that 80% of people worldwide rely on herbal medicines for some part of their primary health care. In Germany, about 600 - 700 plant-based medicines are available and are prescribed by some 70% of German physicians. In the last 20 years in the United States, public dissatisfaction with the cost of prescription medications, combined with an interest in returning to natural or organic remedies, has led to an increase in herbal medicine use.
How do herbs work?
In many cases, scientists aren' t sure what specific ingredient in a particular herb works to treat a condition or illness. Whole herbs contain many ingredients, and they may work together to produce a beneficial effect. Many factors determine how effective an herb will be. For example, the type of environment (climate, bugs, soil quality) in which a plant grew will affect it, as will how and when it was harvested and processed.

How are herbs used?
The use of herbal supplements has increased dramatically over the past 30 years. Herbal supplements are classified as dietary supplements by the U.S. Dietary Supplement Health and Education Act (DSHEA) of 1994. That means herbal supplements -- unlike prescription drugs -- can be sold without being tested to prove that they are safe and effective. However, herbal supplements must be made according to good manufacturing practices.
The most commonly used herbal supplements in the U.S. include echinacea (Echinacea purpurea and related species), St. John's wort (Hypericum perforatum), ginkgo (Ginkgo biloba), garlic (Allium sativum), saw palmetto (Serenoa repens), ginseng (Panax ginseng, or Asian ginseng; and Panax quinquefolius, or American ginseng), goldenseal (Hydrastis canadensis), valerian (Valeriana officinalis), chamomile (Matricaria recutita), feverfew (Tanacetum parthenium), ginger (Zingiber officinale), evening primrose (Oenothera biennis), and milk thistle (Silybum marianum).
Often, herbs may be used together because the combination is more effective and may have fewer side effects. Health care providers must take many factors into account when recommending herbs, including the species and variety of the plant, the plant's habitat, how it was stored and processed, and whether or not there are contaminants (including heavy metals and pesticides).
What is herbal medicine good for?
Herbal medicine is used to treat many conditions, such as asthma, eczema, premenstrual syndrome, rheumatoid arthritis, migraine, menopausal symptoms, chronic fatigue, and irritable bowel syndrome, among others. Herbal supplements are best taken under the guidance of a trained health care provider. Be sure to consult with your doctor or pharmacist before taking any herbs. Some common herbs and their uses are discussed below.
• Ginkgo (Ginkgo biloba)
has been used in traditional medicine to treat circulatory disorders and enhance memory. Although not all studies agree, ginkgo may be especially effective in treating dementia (including Alzheimer's disease) and intermittent claudication (poor circulation in the legs). It also shows promise for enhancing memory in older adults. Laboratory studies have shown that ginkgo improves blood circulation by dilating blood vessels and reducing the stickiness of blood platelets. By the same token, this means ginkgo may also increase the effect of some blood-thinning medications, including aspirin. People taking blood-thinning medications should ask their doctor before using ginkgo.
• Kava kava (Piper methysticum)
is said to elevate mood, well-being, and contentment, and produce a feeling of relaxation. Several studies have found that kava may be useful in the treatment of anxiety, insomnia, and related nervous disorders. However, there is serious concern that kava may cause liver damage. It's not clear whether the kava itself caused liver damage in a few people or whether it was taking kava in combination with other drugs or herbs. It's also not clear whether kava is dangerous at previously recommended doses, or only at higher doses. Some countries have taken kava off the market. It remains available in the United States, but the Food and Drug Administration (FDA) issued a consumer advisory in March of 2002 regarding the "rare" but potential risk of liver failure associated with kava-containing products.
• Saw palmetto (Serenoa repens)
is used by more than 2 million men in the United States for the treatment of benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland. A number of studies suggest that the herb is effective for treating symptoms, including too-frequent urination, having trouble starting or maintaining urination, and needing to urinate during the night. But a well-conducted study published in the February 9, 2006 edition of the New England Journal of Medicine found that saw palmetto was no better than placebo in relieving the signs and symptoms of BPH.


• St. John's wort (Hypericum perforatum)
is well known for its antidepressant effects. In general, most studies have shown that St. John's wort may be an effective treatment for mild to moderate depression, and has fewer side effects than most other prescription antidepressants. But the herb interacts with a wide variety of medications, including birth control pills, so it is important to take it only under the guidance of a health care provider.

• Valerian (Valeriana officinalis)
is a popular alternative to commonly prescribed medications for sleep problems because it is considered to be both safe and gentle. Some studies bear this out, although not all have found valerian to be effective. Unlike many prescription sleeping pills, valerian may have fewer side effects such as morning drowsiness.
• Echinacea preparations (from Echinacea purpurea and other Echinacea species)
may improve the body's natural immunity. Echinacea is one of the most commonly used herbal products, but studies are mixed as to whether it can help prevent or treat colds. A meta-analysis of 14 clinical studies examining the effect of echinacea on the incidence and duration of the common cold found that echinacea supplements decreased the odds of getting a cold by 58%. It also shortened the duration of a cold by 1.4 days.

Buying standardized herbal supplements helps ensure you will get the right dose and the effects similar to human clinical trials. Ask your doctor or pharmacist about which herbal supplements are the best choice for your health concerns.
Is there anything I should watch out for?
Used correctly, herbs can help treat a variety of conditions and in some cases may have fewer side effects than some conventional medications. But because they are unregulated, herbal products are often mislabeled and may contain additives and contaminants that aren' t listed on the label. Some herbs may cause allergic reactions or interact with conventional drugs, and some are toxic if used improperly or at high doses. Taking herbs on your own increases your risk, so it is important to consult your doctor or pharmacist before taking herbal medicines. Some examples of adverse reactions from certain popular herbs are described below.
• St. John's wort can cause your skin to be more sensitive to the sun's ultraviolet rays, and may cause an allergic reaction, stomach upset, fatigue, and restlessness. Clinical studies have found that St. John's wort also interferes with the effectiveness of many drugs, including the blood thinner warfarin (Couamdin), protease inhibitors for HIV, birth control pills, certain asthma drugs, and many other medications. In addition, St. John's wort should not be taken with prescribed antidepressant medication. The FDA has issued a public health advisory concerning many of these interactions.
• Kava kava has been linked to liver toxicity. Kava has been taken off the market in several countries because of liver toxicity.
• Valerian may cause sleepiness, and in some people it may even have the unexpected effect of overstimulating instead of sedating.
• Garlic, ginkgo, feverfew, and ginger, among other herbs, may increase the risk of bleeding.
• Evening primrose (Oenothera biennis) may increase the risk of seizures in people who have seizure disorders.
Some herbal supplements, especially those imported from Asian countries, may contain high levels of heavy metals, including lead, mercury, and cadmium. It is important to purchase herbal supplements from reputable manufacturers to ensure quality. Talk to your health care provider for more information.
Who is using herbal medicine?
Nearly one-third of Americans use herbs. Unfortunately, a study in the New England Journal of Medicine found that nearly 70% of people taking herbal medicines (most of whom were well educated and had a higher-than-average income) were reluctant tell their doctors that they used complementary and alternative medicine. Many herbs can interact with prescription medications and cause unwanted or dangerous reactions. Be sure to consult your doctor before trying any herbal products.
How is herbal medicine sold in stores?
The herbs available in most stores come in several different forms: teas, syrups, oils, liquid extracts, tinctures, and dry extracts (pills or capsules). Teas can be made from dried herbs left to soak for a few minutes in hot water, or by boiling herbs in water and then straining the liquid. Syrups, made from concentrated extracts and added to sweet-tasting preparations, are often used for sore throats and coughs. Oils are extracted from plants and often used as rubs for massage, either by themselves or as part of an ointment or cream. Tinctures and liquid extracts are made of active herbal ingredients dissolved in a liquid (usually water, alcohol, or glycerol). Tinctures are typically a 1:5 or 1:10 concentration, meaning that one part of the herb is prepared with five to ten parts (by weight) of the liquid. Liquid extracts are more concentrated than tinctures and are typically a 1:1 concentration. A dry extract form is the most concentrated form of an herbal product (typically 2:1 - 8:1) and is sold as a tablet, capsule, or lozenge.
Currently, no organization or agency regulates the manufacture or certifies the labeling of herbal preparations. This means you can't be sure that the amount of the herb contained in the bottle, or even from dose to dose, is the same as what is stated on the label. Some herbal preparations are standardized, meaning that the preparation is guaranteed to contain a specific amount of the active ingredients of the herb. However, it is still important to ask companies making standardized herbal products about their product's guarantee. It is important to talk to your doctor or an expert in herbal medicine about the recommended doses of any herbal products.
Are there experts in herbal medicine?
Herbalists, chiropractors, naturopathic physicians, pharmacists, medical doctors, and practitioners of Traditional Chinese Medicine all may use herbs to treat illness. Naturopathic physicians believe that the body is continually striving for balance and that natural therapies can support this process. They are trained in 4-year, postgraduate institutions that combine courses in conventional medical science (such as pathology, microbiology, pharmacology, and surgery) with clinical training in herbal medicine, homeopathy, nutrition, and lifestyle counseling.
What is the future of herbal medicine?
While still not widely accepted, herbal medicine is being taught more in medical schools and pharmacy schools. More health care providers are learning about the positive and potentially negative effects of using herbal medicines to help treat health conditions. Some health care providers, including doctors and pharmacists, are trained in herbal medicine. They can help people create treatment plans that use herbs, conventional medications and lifestyle changes to promote health.
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(http://www.umm.edu/altmed/articles/herbal-medicine-000351.htm)
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